A hastily formed coalition of medical and social service agencies plans a major outreach effort Friday at a homeless camp in south Minneapolis that has alarmed local authorities and American Indian leaders because of its growing size and health risks.

Health and social workers plan to sweep through the sprawling settlement, offering to help the tent dwellers find housing, medical care and other social services in a concerted push before any attempt by the state to force people off the site, which is situated on land owned by the Minnesota Department of Transportation (MnDOT).

The tent compound, near the intersection of Hiawatha and Cedar Avenues in south Minneapolis, has grown rapidly this summer and is now believed to be the largest homeless encampment ever seen in Minnesota. Groups organizing Friday’s effort include Hennepin County Health Care for the Homeless, St. Stephen’s Human Services and People Incorporated Mental Health Services.

The agencies involved said the unusual effort reflects a growing concern that many of the more than 60 people living at the camp are suffering from serious illnesses and substance-use problems. The encampment has several known cases of a drug-resistant infection from bacteria known as MRSA, or methicillin-resistant Staphylococcus aureus, which can lead to sepsis, pneumonia, bloodstream infections and death. There are also reports of hepatitis C, sexually transmitted illnesses and scabies. Heroin and methamphetamine use is widespread in and around the site, which is littered with used needles.

“This is challenging us to think differently, because what we have been doing is not working,” said David Hewitt, director of the Hennepin County Office to End Homelessness. “This represents a concentrated and cumulative effort that is, to some extent, unprecedented.”

The sprawling encampment has, almost overnight, thrown a light on the depth of Minnesota’s opioid epidemic, particularly in the local Indian community, and the challenges that local officials face in helping the city’s growing population of homeless adults.

The camp consists mostly of Indian men and women who have struggled to find stable housing because of drug addictions, health problems and joblessness. Many of the tent dwellers say they feel safer living in proximity in a large encampment, where they can watch over each other in groups, than being scattered on the streets or in homeless shelters. The concentration of tents has also made it easier for local police and street outreach groups to provide food, water, clean needles and overdose response kits with naloxone, a drug that can counter the effects of opioids.

Still, outreach efforts to date have been uncoordinated and focused mainly on providing immediate relief, such as food and water, to the most vulnerable people at the site. On Friday, health and social service workers will conduct a “massive assessment,” stopping at each tent site and signing people up for public housing waiting lists, officials said. They will also conduct voluntary evaluations, known as “Rule 25” assessments, that determine whether a person has a substance-use disorder and qualifies for publicly funded treatment.

“It’s a major push to bring services to them, rather than wait for them to come to us,” said Travis Earth-Werner, a case manager at the Kola program, which provides support services to homeless Indians, including a nearby drop-in clinic on E. Franklin Avenue.

Organizers said they feel they are in a race against time.

Twice in the past month, MnDOT crews have attempted to clear tent dwellers off the site, which is located along a highway sound wall along Hiawatha Avenue; each time, the campers have returned after the authorities left. Camp dwellers said they were told that a sweep of the encampment could occur as early as next week. Despite repeated requests, MnDOT officials have not disclosed their specific plans for the site except to say, in a statement, that the agency sometimes clears homeless encampments when they become a public safety concern.

“They are finally surrounded by people who really care and are getting them help,” said James Cross, founder of Natives Against Heroin, a 12,000-member street outreach group in Minneapolis that advocates for sobriety. “It would be a travesty if they were removed now, and we will stand arm-in-arm with our brothers and sisters and take over the camp if we have to.”

Wheelchair and catheter

Still, the lack of basic hygiene and health services has become a serious concern. The compound has just one portable toilet, and some tent dwellers bathe in the open by pouring bottles of water over their heads. Many of the new arrivals are sleeping without tents on blankets spread out on the grass.

“It’s heart-wrenching,” said Richard Latterner, treatment manager at the White Earth Opiate Treatment Program in Minneapolis. “There are moms with children who are going without basic medical care.”

On a recent afternoon, one woman sat doubled over in her wheelchair outside her campsite. The woman, who identified herself as Yvonne, said she lost use of her legs after a former boyfriend assaulted her with a knife two years ago. Now homeless and living in a small tent, Yvonne relies on a pair of female campers to help her climb into her wheelchair and secure her catheter bag each morning. The area around her catheter tube has not been cleaned for months and may be infected; Yvonne said she has been unable to call for a doctor’s appointment because someone stole her cellphone.

“I’m not asking for a handout,” said Yvonne, 32. “But I could use a place to wash up. I feel stinky, sweaty and dirty.”

The American Indian Community Development Corp. (AICDC), a nonprofit on E. Franklin Avenue, this week proposed converting a nearby vacant lot into a temporary hygiene station with portable toilets and showers. The lot would also serve as a staging area where nonprofit groups and area churches could provide medical care and drug intervention services, AICDC officials said.

“If we don’t address this now, we will be in the same shape as Portland, Seattle and San Francisco,” said AICDC chief executive Michael Goze, referring to the more permanent homeless encampments on the West Coast. “It’s going to get cold and it’s going to get snowy, and people will be at a crossroads.”

For more than two decades, Houston has had competing parades on Martin Luther King Jr. Day, with organizers lobbing allegations of favoritism and conspiracy at each other and at city officials as the groups battled over permits and preferred starting times.

The state's technology system has been plagued by high-profile failures, and finding someone willing to head the department has proven challenging. "It keeps me up at night," Walz said in an interview.